Democrats, Gov. Jerry Brown at odds over healthcare overhaul

Democratic lawmakers and Gov. Jerry Brown are at odds over how to implement President Obama’s healthcare overhaul in California.

As detailed in the Los Angeles Times, legislators and Brown disagree over how the state should expand Medicaid to more than 1 million low-income Californians, a critical component of the federal Affordable Care Act.

Under proposals passed by both houses of the Legislature last week on mostly party-line votes, individuals earning up to 138% of the federal poverty level – or $15,415 a year – would be newly eligible for Medi-Cal, the state’s public insurance program for the poor.

Having heeded Brown’s calls to slash billions of dollars in services in recent years to help balance the state budget, Democrats see an opportunity to patch holes in public aid programs. They note that Washington picks up the whole cost of the healthcare expansion for the first three years and then phases down to 90%.

The governor wants to scale back some of the benefits the Legislature has proposed, saying the long-term costs could undermine the state’s tenuous fiscal stability.

"Now is not the time, when we are trying to put our fiscal house in order, to go farther" than minimum requirements under the federal law, Toby Douglas, director of the California Department of Health Care Services, said in an interview.

According to the nonpartisan Legislative Analyst’s Office, the state could be on the hook for $300 million to $1.3 billion a year starting in 2020. Despite those estimates, the legislative analyst has urged lawmakers to adopt the expansion, saying it will improve the health of the poor and that the benefits – fiscal and otherwise – will likely outweigh the costs.